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1145 Kentwood Ave. �`
Building Permit Confirmed ❑
Not Required �—
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date ----------------------//— /.S — ?3 `.
--------------------- -- Ig-....... Permit No.---- -------
J
The undersigned hereby me ke I'c Plu�jn�g In or of the City of San Jose
for a permit fo ins}all plumbing d s Nerd) verse side.
Exemption from requirement or S4 of ifo tw {o on}r ctor's License is hereby Claimed
by undersigned: as ow er ❑ statement filed ❑
Undersigned attests that his State of he,sorn�jh. c}or' j p4s/
is in full force and effect and properly authorises �h' is o �!/�(/
San Jose City Business License #—Y O IR-
I certify that in the performance of the work for which this permit is issued I shall not employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER S3 002 O Al
ADDRESS // `fJ /fEN7ic,V00 At,, Lot No
USE OF BUILDING IZ&.S
28030 Signed
1145 Kentwood Ave . Ace